Medication Administration

Medication Administration
Medication Rights		Triple Check
■ Right Pt ■ Right medication ■ Right dose ■ Right time ■ Right route		■ When obtaining medication from where it is stored. ■ Side-by-side comparison of medication and written order and MAR. ■ One last time after preparation, just before administration.
Approximate Onset			Assessment and Documentation
IV	3–5 minutes		■ Assessment needs vary and depend on route and medication.
IM	3–20 minutes		■ Always assess Pt after giving drugs that may adversely affect RR, HR, BP, LOC, and blood glucose.
SC	3–20 minutes		■ Assess meds for their efficacy and adverse drug reaction (ADR).
PO	30–45 minutes		■ Document: Drug, dose, route, time given, and time discontinued if applicable. Include Pt’s response and any ADR.
These onset times are only approximate, but will help guide you in your assessment.
Aspirate (IM and SC Injections)
■ The reason for aspirating before actually injecting medication is to ensure that the needle is not in a blood vessel. ■ If blood appears in syringe, withdraw needle, discard syringe, and prepare new injection.
When Not to Aspirate
■ When administering SC anticoagulants (e.g., heparin) or insulin, it is recommended that you do not aspirate. ■ Entering a blood vessel is unlikely with SC injection, and manipulating the syringe is more likely to cause bruising. ■ Aspiration while administering anticoagulants increases risk of bleeding and bruising.
Points to Remember
■ Confirm MAR is up to date. Question unclear medication orders. ■ Always confirm compatibility. ■ Always check for allergies and assess for reactions to new drugs not previously taken by Pt. ■ Do not crush sustained-release or enteric-coated capsules or pills. ■ Take VS before and 5 minutes after applying NTG paste and administration of IV vasoactive meds. ■ Always use filter needle when withdrawing medication from glass ampule (discard and replace filter needle before injection). ■ Use straw for PO iron to prevent staining of Pt’s teeth.